Is Routine Screening Less Than a Year After Benign Breast Biopsy Worth the Cost?

Many times, a suspicious area in the breast found by a mammogram or other imaging test is biopsied and found to be a benign (not cancer) abnormal area. When this happens, doctors often recommend a more aggressive screening plan because they’re concerned that the benign abnormal area may be linked to a higher risk of breast cancer. The National Comprehensive Cancer Network (NCCN) supports this approach, recommending that screenings be done every 6 to 12 months for 1 or 2 years in women who’ve had a benign abnormal area that’s been biopsied.

A small study suggests that having routine screening tests, such as a mammogram or MRI, less than a year after a benign breast biopsy greatly increase the cost of care, but offer few benefits.

The results show that the costs of screening tests less than a year after a benign biopsy end up being about $200,000 per cancer found because so few cancers are found in that time period.

The study, “The Value of Six Month Internal Imaging Following Benign Radiologic-Pathologic Concordant Minimally Invasive Breast Biopsy,” was presented at the 2013 American Society of Breast Surgeons Annual Meeting.

This study was a retrospective study, which means the researchers analyzed information that had been collected before the study was designed. Retrospective studies aren’t considered as good as studies that are designed first and then collect new information specifically for that study.

Also, this study only looked at information from one facility, which means we may not be able to apply the results to a wider group of women.

To see how many cancers were found by routine screening done less than 1 year after a benign breast biopsy, the researchers reviewed the records of 689 women who had image-guided needle biopsy in 2010:

188 women were diagnosed with cancer (27%)

3 women had non-breast cancer pathology (0.4%) – this means cancer was found but it wasn’t breast cancer

498 women had benign results (72.3%); of these women, 44 also had an incisional biopsy (which is more like regular surgery) because abnormal looking cells or non-malignant lesions were found by the needle biopsy

Of the women with benign results who didn’t have an incisional biopsy, 169 had routine screening less than 1 year after the benign results; 33 of the women had more than one imaging study. So the researchers analyzed a total of 204 imaging studies that were done less than 1 year after benign biopsy results. Ultimately, only one breast cancer was diagnosed.

It’s unlikely that the results of this single study will change NCCN guidelines. More research is necessary to see if waiting a year or more after a benign breast biopsy to have a screening test makes more sense than the current standard.

If you’ve had a breast biopsy with benign results, this study should be reassuring. As you develop a breast cancer screening plan with your doctor, you might want to talk about this study. Together, you can create a screening plan that makes the most sense for your unique situation.